45D2216167 CLIA NUMBER - WALGREENS #11273

Laboratory Demographics

  • CLIA Code: 45D2216167
  • Facility Name: WALGREENS #11273
  • Facility Address: 527 E HIGHWAY 190
    COPPERAS COVE, TX
    ZIP 76522
  • Facility Phone: 254 547-1630
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AIMEE LUSSON
  • NPI Number: 1124211065
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2216167
LAB Type Pharmacy
Facility Name WALGREENS #11273
Street 527 E HIGHWAY 190
City COPPERAS COVE
State TX
ZIP 76522
Phone 254 547-1630
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2025
Certificate Expiration Date 3/9/2027
Facility Type Pharmacy
Lab Director AIMEE LUSSON

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This page was last updated on: 9/29/2025